Nebraska False Medicaid Claims Act

Under the Nebraska False Claims Act, Neb. Rev. Stat. 68-936, the Attorney General may seek recovery of damages and imposition of civil penalties for false claims relating to payment of state medical benefits.

The act imposes civil liability for false claims for payment or other compensation submitted to the state. A violation of the act may result in payment of three times the damages to the state and imposition of civil penalties up to $10,000 for each violation.

However, unlike the federal False Claims Act and the majority of state False Claims Acts, the Nebraska False Claims Act contains no qui tam provision or other mechanism for an individual to bring an action or seek a portion of the government’s recovery.

An individual with knowledge of fraud may, however, bring an action under the federal False Claims Act if the false claims also implicated federal funds. For example, a false claim for Medicaid reimbursement may be pursued under the False Claims Act for the portion of the reimbursement paid by the federal government.

The text of the state FCA statute below is believed to be a complete, current version of the statute currently in force. Nonetheless, attorneys and qui tam relators should rely on the most up to date version of the state’s laws.

Nebraska False Medicaid Claims Act
Neb. Rev. Stat. 68-934 to 68-937

68-934. False Medicaid Claims Act; act, how cited.

Sections 68-934 to 68-935 shall be known and may be cited as the False Medicaid Claims Act.

68-935. Terms, defined.

For purposes of the False Medicaid Claims Act:

(1) Attorney General means the Attorney General, the office of the Attorney General, or a designee of the Attorney General;

(2) Claim means any request or demand, whether under a contract or otherwise, for money or property that is made to a contractor, grantee, provider, or other recipient if the state provides any portion of the money or property that is requested or demanded or if the government will reimburse the contractor, grantee, or other recipient for any portion of the money or property that is requested or demanded, whether or not the state pays any portion of such request or demand;

(3) Good or service includes (a) any particular item, device, medical supply, or service claimed to have been provided to a recipient and listed in an itemized claim for payment and (b) any entry in the cost report, books of account, or other documents supporting such good or service;

(4) Knowing or knowingly means that a person, with respect to information:

(a) Has actual knowledge of such information;

(b) Acts in deliberate ignorance of the truth or falsity of such information; or

(c) Acts in reckless disregard of the truth or falsity of such information;

(5) Person means any body politic or corporate, society, community, the public generally, individual, partnership, limited liability company, joint-stock company, or association; and

(6) Recipient means an individual who is eligible to receive goods or services for which payment may be made under the medical assistance program.

68-936. Presentation of false medicaid claim; civil liability; civil penalty; costs and attorney’s fees.

(1) A person presents a false medicaid claim and is subject to civil liability if such person:

(a) Knowingly presents, or causes to be presented, to an officer or employee of the state, a false or fraudulent claim for payment or approval;

(b) Knowingly makes or uses, or causes to be made or used, a false record or statement to obtain payment or approval by the state of a false or fraudulent claim;

(c) Conspires to defraud the state by obtaining payment or approval by the state of a false or fraudulent claim;

(d) Has possession, custody, or control of property or money used, or that will be used, by the state and, intending to defraud the state or willfully conceal the property, delivers, or causes to be delivered, less property than the amount for which such person receives a certificate or receipt;

(e) Buys, or receives as a pledge of an obligation or debt, public property from any officer or employee of the state knowing that such officer or employee may not lawfully sell or pledge such property; or

(f) Knowingly makes, uses, or causes to be made or used, a false record or statement with the intent to conceal, avoid, or decrease an obligation to pay or transmit money or property to the state.

(2) A person who presents a false medicaid claim under subsection (1) of this section is subject to, in addition to any other remedies that may be prescribed by law, a civil penalty of not more than ten thousand dollars. In addition to any civil penalty, a person who presents a false medicaid claim under subsection (1) of this section may be subject to damages in the amount of three times the amount of the false claim submitted to the state due to the act of such person.

(3) If the state is the prevailing party in an action under the False Medicaid Claims Act, the defendant, in addition to penalties and damages, shall pay the state’s costs and attorney’s fees for the civil action brought to recover penalties or damages under the act.

(4) Liability under this section is joint and several for any act committed by two or more persons.

68-937. Failure to report.

A person violates the False Medicaid Claims Act, and is subject to civil liability as provided in section 68-936, if such person is a beneficiary of an inadvertent submission of a false medicaid claim to the state, and subsequently discovers and, knowing the claim is false, fails to report the claim to the department within sixty days of such discovery. The beneficiary is not obliged to make such a report to the department if more than six years have passed since submission of the claim.

Nebraska State Legislature